Neglected Tropical Diseases or NTDs are a group of infectious diseases which primarily affect the poorest sectors of society, especially the rural poor and the most disadvantaged urban populations, predominantly in tropical and subtropical areas. Nearly one billion people in the world suffer from NTDs, which are referred to as “neglected” because they receive little attention from policy-makers, resulting in limited resource allocation and research. These diseases can be controlled, prevented and possibly eliminated using effective & feasible intervention. These ancient diseases of poverty affect the most vulnerable, marginalized populations and impose a devastating human, social and economic burden.
Currently, the World Health Organization (WHO) identifies 20 major diseases as NTDs. Of these, the major issues in West Bengal are Kala-azar or Leishmaniasis, Filaria or Lymphatic Filariasis, Leprosy, Soil transmitted Helminths, Dengue & Chikungunya, Rabies, and Snake bite envenoming, trachoma, etc.
Amongst these, diseases like Kala-azar or Leishmaniasis, Rabies, Snakebite, Dengue not only affect a large number of people, but carry high chances of death or physical deformity or serious illness, if not detected early or treated late. Other diseases like Leprosy or Lymphatic Filariasis, Post Kala-azar dermal leishmaniasis cause visible deformities such as skin rash, swellings in body parts, ulcers leading to disabilities. Affected persons are stigmatized, discriminated against and thus kept from participating in normal family or community life
Leprosy is one of the oldest diseases known to humankind. The disease primarily affects skin and peripheral nerves, which can lead to crippling deformities of the hands, feet, and face if left undiagnosed or untreated. The disease disproportionately affects the poor and other vulnerable and marginalized population groups. Persons affected by leprosy are often exposed to stigma, prejudice, discrimination, and ostracism.
Soil-transmitted helminth infections have pronounced impact on child growth and development. The first ‘‘proven’’ epidemic of dengue in India occurred first in Kolkata and then Eastern coast in 1963–1964, subsequently reaching the entire country. Although initially a largely urban disease, dengue has now spread to rural areas with dengue cases occurring throughout the year.
In India, rabies is transmitted commonly by dogs and cats (97%), followed by wild animals (2%) such as mongoose, foxes, jackals, and wild dogs, and occasionally by horses, donkeys, monkeys, cows, goats, sheep, and pigs. If any animal bite takes place, immediately wash the bite spot with clean water and soap for at least 15 minutes and take the patient to the nearest health facility for vaccination against rabies. Don’t take a risk because, if not vaccinated, then the probability of dying from rabies is 100%. Another very important problem of the rainy season in villages of West Bengal is snake bite. If snake bite is suspected, take the patient immediately to the nearest hospital so that the patient receives anti-snake venom which is the only lifesaving treatment.
West Bengal have achieved major milestones in controlling neglected tropical diseases. For the last 3 years, Kala-azar elimination level has been achieved and maintained. The Government is providing indoor residual spray to homes of people at risk twice a year along with provision of free diagnostics and treatment. More than 60% of the districts have been able to stop active transmission of Filariasis, which in fact is a big indicator of success. In the leprosy programme, deformity cases are decreasing, and no child cases are reported.
As we celebrate World Neglected Tropical Diseases Day, today on January 30, our prime focus is to bring enhanced advocacy for the diseases which get little global attention as mostly the poor get afflicted by these diseases. Their voices are not heard.
The World Health Organization (WHO) formally launched its new roadmap for neglected tropical diseases on World NTD Day, 28 January 2021. The main aim is strengthening national health systems’ response to NTDs through cross-sectoral, integrated interventions, smart investments and community engagement. can strengthen and sustain health systems. The roadmap sets global targets and milestones to prevent, control, eliminate and eradicate 20 neglected tropical diseases (NTDs). It aims to improve coordination and collaboration by shifting away from single-disease vertical programmes to integrated approaches. Another distinct feature is to emphasize greater ownership by national and local governments, including communities. The overarching 2030 global targets are to: reduce by 90% the number of people requiring treatment for NTDs and reduce by 75% the disability-adjusted life years (DALYs) related to NTDs.
Preventing stigma and discrimination remains a challenge, along with the social displacement of people affected by NTDs. Training for health staff may be required to increase their awareness of how stigma and discrimination in communities can lead families to discourage their relatives with disfiguring diseases from attending health services, particularly if they are disabled and require assisted travel. More public awareness along with social and community engagement is essential.
Renewed efforts to eliminate NTDs should occur in ways that help strengthen health systems. For this reason, improved health services and access to drugs must be accompanied by increased community awareness. Strengthening health services through Universal Health Care is key to ensure that people affected by NTDs have access to quality health care throughout their lives. The Government of West Bengal has taken several initiatives in providing improved access to essential medicines, diagnostics and devices for primary health care in priority NTDs. Compensation for wage losses are provided to encourage treatment completion. The WHO NTD Division is complementing the Government’s initiative through planning, advocacy and facilitation of major activities on priority NTDs to improve surveillance; Capacity Building and providing technical guidance for priority NTDs; assessment and evaluation of services, surveys and campaigns. The NTD program in India is also supported by the Bill and Melinda Gates Foundation.
World NTD Day is a time to acknowledge our successes. World NTD Day provides an opportunity for the Ministry of Health, State Health Authorities, communities in West Bengal to renew their commitment to make every effort to work together to eliminate NTDs, reduce stigma and discrimination and reduce the impact on persons affected.